Medical journals have been chronicling the latest scientific advancements for centuries - sharing medical knowledge for the first time in the late 1700s, documenting the first public demonstration of anesthesia in 1846, carrying the first reports in the 1950s that linked lung cancer to smoking.

But, aside from providing online versions, many of these journals have remained relatively unchanged by the social-media tools that have transformed communication and media. The information has remained locked up behind pay walls, inaccessible to the general public and those unable to pay hefty fees to subscribe to or even view a single article.

John Adler, a Stanford neurosurgeon, finally had enough and started his own journal, one with a decidedly Silicon Valley bent.

Cureus (pronounced "curious") is an "open source" online medical journal that shares material, is available and free to anyone, and allows researchers to publish their findings at no cost within days - rather than the months or even years it typically takes for research to be made public. It's built on a "crowdsourcing" platform that allows readers to rate material based on the article's quality, rather than the mere fact it was published in a prestigious publication.

"We're trying to take the huge revolution in communication and blend it with the medical world," said Adler, who has published more than 200 papers in traditional medical journals throughout his career. "Nowadays, you wouldn't go to a restaurant without Yelping it first. You wouldn't go see a movie without seeing what Rotten Tomatoes had to say about it. But medical journals are still stuck in this 200-year-old paradigm."

Despite the vast volume of materials produced by this $8 billion industry, about 85 percent remains trapped behind pay walls that charge hundreds or even thousands of dollars in subscription fees a year. To view a single article costs at least $30.

A few publications have made progress - the New England Journal of Medicine makes information available six months after publication, and the British Medical Journal offers immediate open access for most articles.

But with the exception of "abstracts" that briefly outline an article, the information in medical journals is largely out of reach to patients seeking knowledge about their conditions or wanting to find the experts doing the latest research.

"The average Joe has little to no access to the medical literature today," Adler said. "It's not right. It should be a human right."

Adler, who draws inspiration from his son, Trip, founder and chief executive of the social publishing company Scribd, has spent the last three years developing the model and assembling an editorial board. The journal, which has offices in Palo Alto's Varian Medical Systems, where Adler serves as vice president, has five full-time employees and has already published about 80 papers.

Moving to shared data

Cureus is hardly the first journal to go the open-access route, which is part of a growing movement in science to share data and encourage collaboration. PLOS, which stands for Public Library of Science, was founded a decade ago by UC Berkeley and Stanford scientists.

"We wanted the system to be different and spent a lot of time trying to convince other people to change. Having failed at that, we had to convince other people it could be done," said Michael Eisen, a UC Berkeley biologist and co-founder of PLOS, which publishes PLOS One and other journals. "PLOS has turned out to be a successful business and that has greased the wheels for a lot of people interested in publishing."

PLOS, which is on pace to publish 50,000 articles this year, requires authors to pay $1,300 to publish an article, but is free to view and does not rely heavily on advertising.

Adler said Cureus expects to derive its revenue from advertising since its primary reading audience - doctors - are likely to make medical and financial decisions based on what they learn in medical journals.

Another medical and biological journal, PeerJ, started accepting submissions earlier this month for articles to be published in January. The journal, founded by former PLOS One editor Peter Binfield, has offices in London and Corte Madera, making the Bay Area a center for alternative scientific publications.

A different model

PeerJ operates on yet a different business model - one that requires authors to pay $99 for a one-time, lifetime membership fee, which allows one publication a year and up to $299 for an unlimited publishing privileges. While the information will be freely available, Binfield said most content is highly technical and written for other researchers.

"Open access is about to become the dominant way of publishing academic material and completely disrupt the subscription model," Binfield said. "You're seeing an epicenter here, which is not a traditional place for academic publishing."

But the Bay Area, and Silicon Valley in particular, has long been an epicenter for innovation in communication and research.

"It's fantastic that researchers, especially researchers with great reputations, are willing to put themselves on the line and experiment with (these new ways of publishing)," said Heather Joseph, executive director of Scholarly Publishing and Academic Resources Coalition in Washington, D.C. "This has been one of the slowest places to make change."

But openness and democratization of medical and scientific articles does not mean that all forms of verification or assessment by the scientific community completely go by the wayside.

Swifter peer review

The main way of putting a stamp of approval on a research paper is a process known as "peer review." Journal editors ask experts to make sure the article meets acceptable standards prior to publication. That can take months.

At Cureus, editors will ask a large number of experts to review an article in a matter of days, Adler said.

Following publication, readers will be able to rate an article, although experts in the subject area will be accorded a higher weighted score.

Esserman, who serves on Cureus' editorial board, has published more than 250 research articles in traditional journals, but felt it made sense to publish this one in Cureus.

"This is an article about how to accelerate our ability to learn and identify the right drugs for a specific population of patients, and that really is the concept of personalized medicine," Esserman said. "It's particularly well suited to this (journal). Everything about the trial is a little different."

Adler said he sees everyone benefiting from the expanded access to information, except possibly the traditional medical journals. "We aspire to be the journal, not just a journal," he said.

Cureus online

To read Cureus, a medical journal that is free to publish and view, visit: www.cureus.com